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Question: I was looking at the PCP Medical Cardiac Arrest Medical Directive. I understand that we can give IM epinephrine in the setting of an anaphylaxis induced VSA. In the event of a ROSC from this type of VSA can Benadryl be administered IM/IV? Is there any benefit to doing this?

Answer: A patient who has suffered an out of hospital cardiac arrest and now has achieved ROSC is perhaps one of the most unstable patients a paramedic will manage pre-hospital. In the situation above, there is low likelihood that the administration of Benadryl to a post arrest patient with ROSC will achieve any benefit and may delay transport. As such, paramedics should follow their Medical Cardiac Arrest Medical Directive as well as the ROSC Medical Directive and initiate rapid transport.